1. Field of the Invention
The present invention relates to surgical devices and methods, and, more particularly, to devices and methods for providing an instrument portal into the uterus.
2. Description of Related Art
The evolution of surgical procedures has been along a path of decreasing invasiveness. Such changes have been advanced by the introduction of systems permitting external visualization of procedures and devices that are externally manipulable.
In the obstetrical/gynecological arena, for example, access into the uterus and fallopian tubes can be achieved by inserting a speculum into the vagina and performing a dilatation of the cervix if necessary or desired, such as with the use of cervical clamps. Visualization and manipulation instruments can then be inserted through the speculum opening to carry out a desired procedure. Among the devices currently used is a flexible hysteroscope, which may include visualization means such as fiber optic illumination and viewing elements and forceps-type grasping jaws.
A particular problem with the current devices and methods, however, is that multiple placements of the speculum are usually required, and the cervix is difficult to restrain in a dilated position, as it is biased to a closed position.
Laparoscopic trocars are known in the art for insertion through tissue to obtain access to an internal organ. Their design is predicated on the cylindrical portion of the trocar remaining in place in the skin, and it is typically desired to keep the hole in the skin as small as possible. Such trocars have been designed with balloons, but these balloons are for retaining that section of the trocar within the body""s interior.
It is therefore an object of the present invention to provide a device for passing an instrument into the uterus through the cervix.
It is an additional object to provide such a device that retains the cervix in a dilated state.
It is a further object to provide such a device whose insertion is not damaging to the bodily tissue.
It is another object to provide a method of performing a gynecological procedure.
An additional object is to provide a method of making a device for passing instrument into a uterus.
These objects and others are achieved by the device and methods of the present invention. The device comprises an elongated generally cylindrical cannula having a proximal and a distal opening and a lumen therebetween. The cannula is dimensioned for insertion through a vagina to penetrate a cervix. Means are positioned adjacent the distal end of the cannula for dilating the cervix and for maintaining the cervix in a dilated state. The dilatation means are manipulable between a narrowed insertion and withdrawal position and an expanded dilatation position. The dilatation means have a surface adapted to resist slippage against the cervical surface.
The device also comprises an introducer having a generally cylindrical distal portion dimensioned for insertion through the cannula lumen and sufficiently long to extend beyond the cannula""s distal end. The introducer""s distal tip is tapered for ease of insertion, but is preferably smooth to prevent tissue damage. The introducer also has a proximal portion adapted to protrude from the cannula""s proximal opening and having means for being grasped for insertion into and removal from the cannula.
The features that characterize the invention, both as to organization and method of operation, together with further objects and advantages thereof, will be better understood from the following description used in conjunction with the accompanying drawing. It is to be expressly understood that the drawing is for the purpose of illustration and description and is not intended as a definition of the limits of the invention. These and other objects attained, and advantages offered, by the present invention will become more fully apparent as the description that now follows is read in conjunction with the accompanying drawing.